Swedish Child Health Care nurses conceptions of overweight in children: a qualitative study

Abstract

BackgroundRegistered Sick Children’s Nurses and District Nurses employed at Child Health Care centres are in a position to help prevent childhood overweight and obesity. Prevention of this challenging public health threat could be improved through having a better understanding of how this group of nurses perceives childhood obesity. The aim of this study was to elucidate the conceptions of childhood overweight, including obesity, among nurses working in Child Health Care.MethodA qualitative study using a phenomenographic approach, based on open-ended interviews with 18 Child Health Care nurses (CHC-nurses) strategically selected from 17 Child Health Care Centres in the southern part of Sweden.ResultsFour categories of description emerged from the data: Perception of childhood overweight changes, Overweight in younger children a neglected concern, Overweight a delicate issue and Importance of family lifestyle. The participating CHC-nurses conceived overweight in children, primarily obesity in children to be an extensive and serious problem which affects children, families and the surrounding society. Overweight in children was further perceived as a consequence of their parent’s lifestyle and their awareness of the problem, which was considered by the CHC-nurses as a sensitive and a provoking issue. It was also perceived that overweight in children is not taken seriously during the pre-school period and that concerns regarding overweight in younger children were mainly about the appearance and not the health of the child. The CHC-nurses perceived that the proportion of overweight children has increased, which Swedish society and the CHC-nurses have adapted to. This adaptation makes it difficult for CHC-nurses to define those children who are overweight.ConclusionCHC-nurses provide a comprehensive and complex picture of childhood overweight, which includes several difficulties dealing with this issue. Attention to CHC-nurse’s conceptions of overweight in children is important since it can affect the parent-nurse relationship and thereby the nurse’s, as well as the parent’s efforts to influence the children’s weight. It is suggested that CHC- nurses should work with person centered counseling and empowerment concerning parent to child relations in cases involving overweight.

Communicating with children and families about obesity and weight‐related topics: a scoping review of best practices

“…Across all three categories of articles, there was support for involving all relevant stakeholders (HCPs, children, parents and potentially other family members) in conversations regarding weight . While one lived experience paper suggested that HCPs should talk with parents without the child present , others recommended that HCPs speak directly to older children and teens , especially once they are old enough to participate in extra‐curricular physical activity activities .…”

“…Some authors suggested that HCPs use parents’ non‐verbal cues (e.g. facial expressions or body positioning) to indicate whether to continue discussions about weight , and potentially switch to other communication methods (e.g. written information) if parents appear angry or defensive .…”

Obstacles to the prevention of overweight and obesity in the context of child health care in Sweden

“…The first part covered the CHC-nurses conceptions of childhood overweight [16]. An interview guide with open-ended questions was developed, relating to the aim of this study.…”

School Nurses’ Experiences With Motivational Interviewing for Preventing Childhood Obesity

“…Qualitative research has added to the survey findings that school nurses perceived overweight and obesity as difficult issues to deal with when communicating with parents. In addition, the nurses perceived barriers in both a lack of parental recognition of their child's overweight being a problem and a lack of parental support for prevention efforts (Isma, Bramhagen, Ahlstrom, Ö stman, & Dykes, 2012; Morrison-Sandberg, Kubik, & Johnson, 2011). A study of audiorecorded counseling sessions between school nurses and overweight children indicated inadequate communication skills in the nurses (Magnusson, Kjellgren, & Winkvist, 2012).…”